• Increase Text Icon
  • Decrease Text Icon
  • Email Icon
  • Print this page
You are here: Home . wc . pbo . pbo

Performance Based Oversight (PBO)

Contents:

What Is PBO? | Purpose Of PBO | Applicable Statute & Rules | PBO Planning Documents

What is Performance Based Oversight (PBO)?

As a regulatory agency, the Texas Department of Insurance, Division of Workers' Compensation (TDI-DWC) is required to monitor system participants' compliance with the Texas Workers' Compensation Act and Rules and to address noncompliant behavior. Compliance objectives are achieved through Performance Based Oversight (PBO), data monitoring, complaint resolution, entity audits, and when appropriate, enforcement actions.

As part of the overall compliance plan, Section 402.075 of the Texas Labor Code mandates the TDI-DWC to, at least biennially, assess the performance of insurance carriers and health care providers. Based on the performance assessment, insurance carriers and health care providers will be placed into regulatory tiers: poor performers, average performers, and consistently high performers. The TDI-DWC must then focus its regulatory oversight on the poor performers. Starting in 2010, the insurance carriers will be assessed in even numbered years (2010, 2012, etc.) and the health care providers will be assessed in odd numbered years (2011, 2013, etc.).

What is the purpose of Performance Based Oversight (PBO)?

"House Bill 7, 79th Legislature, 2005 (Regular Session)" requires establishment of a performance-based oversight system that includes development of key regulatory goals for assessing insurance carriers and health care providers, tiering of insurance carriers and health care providers based on performance, and development of regulatory incentives to promote compliance. The TDI-DWC's regulatory resources will be focused more strategically on overall compliance issues and history affecting an insurance carrier or a health care provider, placing emphasis on system participants with continuing compliance problems in the workers' compensation system.

The purpose of PBO is to:

  • Encourage and reward excellence and continuous improvement;
  • Foster improved and timely communications;
  • Establish performance objectives, measures and expectations; and
  • Focus on results rather than prescriptive requirements.

Back to top

Applicable Statute & Rules

Texas Labor Code §402.075 Incentives; Performance-Based Oversight
28 Texas Administrative Code (TAC) §180.19 Incentives

Back to top

PBO Planning Documents

PBO Key Regulatory Goals
· Key Regulatory Goals (pdf)

PBO Instruments
· Potential Assessment Measures Instrument (pdf)
· DWC Available Data (pdf)

PBO Meetings

9/17/2015 Meeting agenda, presentation

11/5/2015 Meeting agenda

Back to top



For more information, contact:

Last updated: 01/11/2017

Contact Information and Other Helpful Links